A pilot study of game-based learning programs for childhood cancer survivors

Abstract

Background Childhood cancer survivors lacking awareness on their potential risks of late effects often fail to seek adequate follow-up care. Patient education matching their preference is of great importance to improve their adherence to survivorship care. In this study, we developed two age-dependent game-based learning programs, which enable continuous approaches for childhood cancer survivors along their intellectual maturation. Then, we assessed the effectiveness of the programs. Methods Childhood cancer survivors over 10 years of age who regularly visited a long-term follow-up clinic were enrolled in this study. They were requested to play either of two different types of game tools, one for school children and another for adolescents and young adults, for one month at home. To evaluate the educational effects of the programs, they were examined for health management awareness, self-esteem, and knowledge on cancer-related late effects before and after the intervention with age-based questionnaires and knowledge tests. Results Among 83 participants, 49 (59.0%) completed the assessments over the period of 12 months. The health management awareness and knowledge levels increased significantly at 1-month after the intervention as compared to the baseline in both school children and adolescents/young adults (for health management awareness, p = 0.011 in elementary school children; p = 0.007 in junior high school children; p < 0.001 in adolescents/young adults; for knowledge levels, p < 0.001 in school children; p < 0.001 in adolescents/young adults). The effect was maintained for 12 months in school children while it decreased in adolescents and young adults with time. Self-esteem significantly increased at 1-month (p = 0.002 in school children; p = 0.020 in adolescents/young adults) and was maintained for 12 months in both age groups. Conclusion The game-based learning programs enhanced health locus of control and self-esteem in childhood cancer survivors. The game-based learning programs could be applied effectively to survivorship care as a new modality of patient education. Trial registration This study was retrospectively registered in UMIN-CTR (UMIN000043603) on March 12, 2021.

Investigating the Use of Serious Games for Cancer Control Among Children and Adolescents: Scoping Review

“…Children and adolescents were the main participants represented in the articles included in this review, which aligned with this study's purpose. The adolescents age group had the greatest representation in the included studies-all (8/8, 100%) cancer prevention serious game articles [7,34,[106][107][108][109][110][111] Cancer survivors [54,57,58,80,86,87,91] 0 (0) 7 ( 13) Health professionals [60,63,66,81,82,85,93,94,97] 0 (0) 9 ( 16)…”

“…Serious game preference [7,55,56,62,63,67,68,70,75,79,[84][85][86]90,[92][93][94][95][96][97][98][101][102][103][104]108,110,111] 4 (50) 24 (44) Treatment adherence [69,95,101] 0 (0) 3 ( 6) Cancer education [34,55,56,80,95,101,105,106,109] 3 (38) 6 (11) Healthy behavior promotion [42,54,57,60,65,74,…”

“…The majority of the included studies were published between 2019 and 2023. To be specific, 5 out of 8 (63%) cancer prevention serious game articles[7,106,[109][110][111] and 35 out of 55 (64%) cancer care serious game articles[35,42,54,58,59,[61][62][63]65,66,71,72,74,75,[78][79][80][81][82]85,[91][92][93][94][95][96][97][98][99][100][101][102][103][104][105] were published between 2019 and 2023. The studies were conducted in Asia, Europe, North America, and Oceania, with the majority of the studies being conducted in Europe and North America.…”

“…Of the 8 cancer prevention serious game studies, 3 (38%) were quantitative[34,110,111], 3 (38%) were qualitative[7,107,108], and 2 (25%) were mixed methods studies[106,109]. Of the 55 cancer care serious game studies, 25 (45%) were quantitative[35,42,52,[54][55][56]58,64,69,[71][72][73][74]76,77,80,84,[87][88][89]91,96,97,100,105], 11 (20%) were qualitative…”

“…As mentioned in our inclusion criteria, studies examining adult populations were included if these also examined and isolated data for our population of interest (ie, children and/or adolescents), or if adults were interviewed about children or adolescents. Of our included studies, 25 of the 55 (45%) cancer care articles[52,55,56,[60][61][62][66][67][68][69][79][80][81][82]84,85,[92][93][94][95]97,99,101,102,104] and 2 of the 8 (25%) cancer prevention articles[34,109] included adults as well as adolescents and/or children. Two studies only included adults (being studies where parents were interviewed about their children, but where the children did not participate in the study, themselves), with both of these studies being cancer care articles[63,103].…”